Provider Demographics
NPI:1083807739
Name:JULIAN G FLEMING,M.D.,P.C.
Entity Type:Organization
Organization Name:JULIAN G FLEMING,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ONIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-761-1410
Mailing Address - Street 1:5565 MURRAY RD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3879
Mailing Address - Country:US
Mailing Address - Phone:901-761-1410
Mailing Address - Fax:901-761-2248
Practice Address - Street 1:5565 MURRAY RD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3879
Practice Address - Country:US
Practice Address - Phone:901-761-1410
Practice Address - Fax:901-761-2248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000004227207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3380695Medicare PIN
TNB02032Medicare UPIN